Email this article Clinical characteristics and laboratory findings of patients with COVID-19 in Rasht, Iran
Abstract
In December 2019, an epidemic of an unknown respiratory virus emerged in Wuhan, China, and put the whole world in crisis; a newly emerged coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to evaluate epidemiological and clinical characteristics of coronavirus disease 2019 (COVID-19) patients in the North of Iran. We extracted demographics and baseline clinical characteristics from 126 patients with polymerase chain reaction (PCR) confirmed COVID-19 in Razi Hospital, Rasht, Iran. The mean age of patients was 62 years, ranging from 28 to 92 years old. Overall, 57.1% of cases were male and 42.9% were female. Totally, 17.5% of patients had direct contact with a SARS-CoV-2 infected patient. The most common underlying diseases were diabetes (11.9%) and cardiovascular disease (CVD) (7.1%). The mean±SD of lactate dehydrogenase (LDH), creatine phosphokinase (CPK), creatine kinase MB (CK-MB), serum glutamic oxaloacetic transaminase (SGOT), and erythrocyte sedimentation rate (ESR) were remarkably higher than the normal range, (1231±866.4 U/L, 766.8±2288.6 U/L, 59.28±55.1 U/L, 112.28±213 U/L and 67.61±31 mm/hr), respectively. Also, the average O2 Saturation (O2Sat) was 61.4±26.3%. Male gender, advanced age, a higher level of the cardiac enzyme, and a lower level of O2Sat are associated with severity in COVID-19 patients.
Keywords
Full Text:
Full-text PDFReferences
Pal M, Berhanu G, Desalegn C, Kandi V. Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2): An Update. Cureus. 2020; 12(3):e7423.
She J, Jiang J, Ye L, Hu L, Bai C, Song Y. 2019 novel coronavirus of pneumonia in Wuhan, China: emerging attack and management strategies. Clin Transl Med. 2020; 9(1):19.
Halaji M, Heiat M, Faraji N, Ranjbar R. Epidemiology of COVID-19: An updated review. J Res Med Sci. 2021; 26:82.
Lechien JR, Chiesa-Estomba CM, Place S, Van Laethem Y, Cabaraux P, Mat Q, et al. Clinical and epidemiological characteristics of 1420 European patients with mild-to-moderate coronavirus disease 2019. J Intern Med. 2020; 288(3):335–44.
Pan Y, Li X, Yang G, Fan J, Tang Y, Zhao J, et al. Serological immunochromatographic approach in diagnosis with SARS-CoV-2 infected COVID-19 patients. J Infect. 2020; 81(1):e28–32.
Adhikari SP, Meng S, Wu Y-J, Mao Y-P, Ye R-X, Wang Q-Z, et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infect Dis poverty. 2020; 9(1):29.
Mansury D, Moghim S. Coronavirus disease 2019 (COVID-19): A New Pandemic and its Challenges. J Curr Biomed Rep. 2022; 1(2):52-57.
Nishiga M, Wang DW, Han Y, Lewis DB, Wu JC. COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives. Nat Rev Cardiol. 2020; 17(9):543–558.
Bairwa M, Kumar R, Beniwal K, Kalita D, Bahurupi Y. Hematological profile and biochemical markers of COVID-19 non-survivors: A retrospective analysis. Clin Epidemiol Glob Heal. 2021; 11:100770.
Ghahramani S, Tabrizi R, Lankarani KB, Kashani SMA, Rezaei S, Zeidi N, et al. Laboratory features of severe vs. non-severe COVID-19 patients in Asian populations: A systematic review and meta-analysis. Eur J Med Res. 2020;25(1):30.
Vafadar Moradi E, Teimouri A, Rezaee R, Morovatdar N, Foroughian M, Layegh P, et al. Increased age, neutrophil-to-lymphocyte ratio (NLR) and white blood cells count are associated with higher COVID-19 mortality. Am J Emerg Med. 2021; 40:11-4.
Pirsalehi A, Salari S, Baghestani A, Vahidi M, Khave LJ, Akbari ME, et al. Neutrophil-to-lymphocyte ratio (NLR) greater than 6.5 May reflect the progression of COVID-19 towards an unfavorable clinical outcome. Iran J Microbiol. 2020; 12(5):466–474.
Gholizadeh P, Safari R, Marofi P, Zeinalzadeh E, Pagliano P, Ganbarov K, et al. Alteration of liver biomarkers in patients with SARS-CoV-2 (COVID-19). J Inflamm Res. 2020; 13:285–92.
Zeinali T, Faraji N, Joukar F, Khan Mirzaei M, Kafshdar Jalali H, Shenagari M, et al. Gut bacteria, bacteriophages, and probiotics: Tripartite mutualism to quench the SARS-CoV2 storm. Microb Pathog. 2022; 170:105704.
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020; 382(13):1199–1207.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020; 395(10223):507–513.
Zhang J-J, Dong X, Cao Y-Y, Yuan Y-D, Yang Y-B, Yan Y-Q, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020; 75(7):1730–1741.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020; 323(11):1061–1069.
Klein SL, Flanagan KL. Sex differences in immune responses. Nat Rev Immunol. 2016; 16(10):626–38.
Schröder J, Kahlke V, Staubach KH, Zabel P, Stüber F. Gender differences in human sepsis. Arch Surg. 1998; 133(11):1200–5.
Flanagan KL, Fink AL, Plebanski M, Klein SL. Sex and Gender Differences in the Outcomes of Vaccination over the Life Course. Annu Rev Cell Dev Biol. 2017; 33:577–599.
Laffont S, Rouquié N, Azar P, Seillet C, Plumas J, Aspord C, et al. X-Chromosome complement and estrogen receptor signaling independently contribute to the enhanced TLR7-mediated IFN-α production of plasmacytoid dendritic cells from women. J Immunol. 2014; 193(11):5444–52.
Ziegler SM, Altfeld M. Human Immunodeficiency Virus 1 and Type I Interferons-Where Sex Makes a Difference. Front Immunol. 2017; 8:1224.
Meier A, Chang JJ, Chan ES, Pollard RB, Sidhu HK, Kulkarni S, et al. Sex differences in the Toll-like receptor-mediated response of plasmacytoid dendritic cells to HIV-1. Nat Med. 2009; 15(8):955–9.
Berghöfer B, Frommer T, Haley G, Fink L, Bein G, Hackstein H. TLR7 ligands induce higher IFN-alpha production in females. J Immunol. 2006; 177(4):2088–96.
Imazio M, Klingel K, Kindermann I, Brucato A, De Rosa FG, Adler Y, et al. COVID-19 pandemic and troponin: indirect myocardial injury, myocardial inflammation or myocarditis? Heart. 2020; 106(15):1127–1131.
Tavazzi G, Pellegrini C, Maurelli M, Belliato M, Sciutti F, Bottazzi A, et al. Myocardial localization of coronavirus in COVID-19 cardiogenic shock. Eur J Heart Fail. 2020; 22(5):911-915.
Das BB, Sexon Tejtel SK, Deshpande S, Shekerdemian LS. A Review of the Cardiac and Cardiovascular Effects of COVID-19 in Adults and Children. Texas Hear Inst J. 2021; 48(3):e207395.
Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardiol. 2020; 5(7):802–810.
Mazucanti CH, Egan JM. SARS-CoV-2 disease severity and diabetes: why the connection and what is to be done? Immun Ageing. 2020; 17:21.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020; 395(10223):507-513.
Bhatraju PK, Ghassemieh BJ, Nichols M, Kim R, Jerome KR, Nalla AK, et al. Covid-19 in Critically Ill Patients in the Seattle Region — Case Series. N Engl J Med. 2020; 382(21):2012–2022.
Curbelo J, Luquero Bueno S, Galván-Román JM, Ortega-Gómez M, Rajas O, Fernández-Jiménez G, et al. Inflammation biomarkers in blood as mortality predictors in community-acquired pneumonia admitted patients: Importance of comparison with neutrophil count percentage or neutrophil-lymphocyte ratio. PLoS One. 2017; 12(3):e0173947.
Liu X, Shen Y, Wang H, Ge Q, Fei A, Pan S. Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Patients with Sepsis: A Prospective Observational Study. Mediators Inflamm. 2016; 2016:8191254.
Berhane M, Melku M, Amsalu A, Enawgaw B, Getaneh Z, Asrie F. The Role of Neutrophil to Lymphocyte Count Ratio in the Differential Diagnosis of Pulmonary Tuberculosis and Bacterial Community-Acquired Pneumonia: a Cross-Sectional Study at Ayder and Mekelle Hospitals, Ethiopia. Clin Lab. 2019; 65(4).
Kashani KB. Hypoxia in COVID-19: Sign of Severity or Cause for Poor Outcomes. Mayo Clin Proc. 2020; 95(6):1094–1096.
Xie J, Covassin N, Fan Z, Singh P, Gao W, Li G, et al. Association Between Hypoxemia and Mortality in Patients With COVID-19. Mayo Clin Proc. 2020; 95(6):1138–1147.
Pu S-L, Zhang X-Y, Liu D-S, Ye B-N, Li J-Q. Unexplained elevation of erythrocyte sedimentation rate in a patient recovering from COVID-19: A case report. World J Clin cases. 2021; 9(6):1394–1401.
Hanada M, Takahashi M, Furuhashi H, Koyama H, Matsuyama Y. Elevated erythrocyte sedimentation rate and high-sensitivity C-reactive protein in osteoarthritis of the knee: relationship with clinical findings and radiographic severity. Ann Clin Biochem. 2016; 53(Pt 5):548–53.
Atzeni F, Talotta R, Masala IF, Bongiovanni S, Boccassini L, Sarzi-Puttini P. Biomarkers in Rheumatoid Arthritis. Isr Med Assoc J. 2017; 19(8):512–516.
Brouillard M, Reade R, Boulanger E, Cardon G, Dracon M, Dequiedt P, et al. Erythrocyte sedimentation rate, an underestimated tool in chronic renal failure. Nephrol Dial Transplant. 1996; 11(11):2244–7.
Hess CT. Monitoring laboratory values: transferrin, C-reactive protein, erythrocyte sedimentation rate, and liver function. Adv Skin Wound Care. 2009; 22(2):96.
Lei F, Liu Y-M, Zhou F, Qin J-J, Zhang P, Zhu L, et al. Longitudinal Association Between Markers of Liver Injury and Mortality in COVID-19 in China. Hepatology. 2020; 72(2):389–398.
Shokri Afra H, Amiri-Dashatan N, Ghorbani F, Maleki I, Rezaei-Tavirani M. Positive association between severity of COVID-19 infection and liver damage: a systematic review and meta-analysis. Gastroenterol Hepatol from bed to bench. 2020; 13(4):292–304.
Téllez L, Martín Mateos RM. COVID-19 and liver disease: An update. Gastroenterol Hepatol. 2020; 43(8):472–480.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet . 2020; 395(10229):1054–1062.
Bansal A, Kumar A, Patel D, Puri R, Kalra A, Kapadia SR, et al. Meta-analysis Comparing Outcomes in Patients With and Without Cardiac Injury and Coronavirus Disease 2019 (COVID 19). Am J Cardiol. 2021; 141:140–146.
Walker C, Deb S, Ling H, Wang Z. Assessing the Elevation of Cardiac Biomarkers and the Severity of COVID-19 Infection: A Meta-analysis. J Pharm Pharm Sci. 2020; 23:396–405.
Parohan M, Yaghoubi S, Seraji A. Cardiac injury is associated with severe outcome and death in patients with Coronavirus disease 2019 (COVID-19) infection: A systematic review and meta-analysis of observational studies. Eur Heart J Acute Cardiovasc Care. 2020; 9(6):665–677.
Zheng F, Tang W, Li H, Huang YX, Xie YL, Zhou ZG. Clinical characteristics of 161 cases of corona virus disease 2019 (COVID-19) in Changsha. Eur Rev Med Pharmacol Sci. 2020; 24(6):3404–3410.
Wang JT, Sheng WH, Fang CT, Chen YC, Wang JL, Yu CJ, et al. Clinical Manifestations, Laboratory Findings, and Treatment Outcomes of SARS Patients. Emerg Infect Dis. 2004;10(5):818–24.
Guan Y, Tang X, Yin C, Hong W, Lei C. Study on the myocardiac injury in patients with severe acute respiratory syndrome. Zhonghua nei ke za zhi. 2003; 42(7):458–60.
DOI: https://doi.org/10.52547/JCBioR.3.2.91
Refbacks
- There are currently no refbacks.
Copyright (c) 2022 © The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.